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Journal Title

Title of Journal: Cardiovasc Intervent Radiol

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Abbravation: CardioVascular and Interventional Radiology

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Springer-Verlag

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DOI

10.1002/ange.201508330

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ISSN

1432-086X

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ConeBeam Computed Tomography–Guided Percutaneous

Authors: Markus Möhlenbruch Michael Nelles Daniel Thomas Winfried Willinek Andreas Gerstner Hans H Schild Kai Wilhelm
Publish Date: 2009/07/14
Volume: 33, Issue: 2, Pages: 315-320
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Abstract

The purpose of this study was to investigate the feasibility of a flatdetector Carm–guided radiographic technique conebeam computed tomography CBCT for percutaneous radiologic gastrostomy PRG insertion Eighteen patients 13 men and 5 women mean age 62 years in whom percutaneous endoscopic gastrostomy PEG had failed underwent CBCTguided PRG insertion PEG failure or unsuitability was caused by upper gastrointestinal tract obstruction in all cases Indications for gastrostomy were esophageal and head and neck malignancies respectively Before the PRG procedure initial Carm CBCT scans were acquired Three and 2dimensional softtissue reconstructions of the epigastrium region were generated on a dedicated workstation Subsequently gastropexy was performed with Tfasteners after CBCTguided puncture of the stomach bubble followed by insertion of an 14F balloonretained catheter through a peelaway introducer Puncture of the stomach bubble and PRG insertion was technically successful in all patients without alteration of the epigastric region There was no malpositioning of the tube or other major periprocedural complications In 2 patients minor complications occurred during the first 30 days of followup PRG malfunction n = 1 slight infection n = 1 Late complications which were mainly tube disturbances were observed in 2 patients The mean followup time was 212 days CBCTguided PRG is a safe welltolerated and successful method of gastrostomy insertion in patients in whom endoscopic gastrostomy is not feasible CBCT provides detailed imaging of the soft tissue and surrounding structures of the epigastric region in one diagnostic tour and thus significantly improves the planning of PRG procedures

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